Giving patients back the hope of having a family

Some cancer treatments can harm a patient’s fertility. The University of Florida Health’s Helping Oncofertility Patients become Educated, or HOPE, Network is on a mission to help preserve it.

“The goal of HOPE Network is to try to help young, reproductive age or prepuberty oncology patients understand what their options would be to preserve their fertility,” said Alice Rhoton-Vlasak, M.D., director of the HOPE Network.

The program works toward that goal by offering novel fertility preservation options to UF Health patients. Currently, the HOPE Network is the only fertility program in Florida that is trained in and offering ovarian tissue freezing, which became a standard procedure with published guidelines in January.

“Certain cancer treatments and surgeries can damage or destroy the ovaries and eggs, which leads to early menopause and infertility,” said Rhoton-Vlasak, a professor in the UF College of Medicine’s department of obstetrics and gynecology. “Ovarian tissue freezing is the newest option to preserve fertility.”

The treatment involves removing a piece of or the whole ovary, freezing the extracted ovary in tiny strips containing the follicles with eggs, and transplanting the strips back into the area of the ovary post-cancer. The ovarian tissue can be frozen indefinitely, allowing women to choose to implant the tissue when they want to start a family. When the tissue is transplanted, hormones and menstrual cycles can come back, restoring fertility and allowing natural pregnancy to occur.

“Those transplants don't usually work forever,” Rhoton-Vlasak said. “They have a lifespan of about three to six years. You could potentially transplant back another piece of the woman’s own tissue so that she gets longer benefit from the hormones. Even if they don't want more babies, those hormones are important for your bones and heart until the natural age of menopause.”

When fertility preservation treatments need to happen quickly as a result of a patient’s cancer treatment, the HOPE Network team is available, working around the clock to see patients in their times of need.

“It's important that we can see people rapidly so that we don't delay their cancer treatments,” she said.

One way the program is able to see patients in a timely manner is with the help of the HOPE Network’s inpatient oncology patient navigator, Lauren Staley.

“I would say the biggest difference between what we do at UF Health and what other fertility programs do is that we have an inpatient nurse navigator, so services are available in multiple settings,” Rhoton-Vlasak said.

Staley saves patients a trip out of their hospital rooms by traveling to them, offering consultations and specimen collections in patients’ hospital rooms.

Operated through the division of reproductive endocrinology and infertility in the UF College of Medicine’s department of obstetrics and gynecology, the HOPE Network consists of a diverse team of health care providers including physicians, nurse coordinators, nurse navigators, psychologists, financial counselors, radiologists, surgeons and embryologists.

Some fertility treatments are not covered by insurance, but patients have the opportunity to receive grant funding that is generously donated to the HOPE Network by the Climb for Cancer Foundation, Rhoton-Vlasak said. Over the past seven years, Diane and Ron Farb, founders of Climb for Cancer, have donated thousands of dollars in grants to help build the program, covering resources such as patient education brochures, provider meetings and patient consultations.

The HOPE Network offers a variety of fertility treatment options for men and women. Men have the option of sperm banking, while women may freeze eggs, freeze embryos or use a medicine that may protect the ovaries from chemotherapy.

“Almost 100% of postpubertal male patients will bank sperm; it's less expensive and causes no therapy delays,” Rhoton-Vlasak said. “For female patients, fertility preservation options are more complex and take more time, visits and money so less women do it, but probably an equal number of men and women get counseling at UF Health.”

The HOPE Network lives up to its name — giving patients back the hope of having a family.